Death anxiety may impact several clinical parameters in cancer patients receiving palliative care

1. In this study, scores on the Death Anxiety and Distress Scale (DADDS) were positively correlated with both religious struggle and dignity-related distress in cancer patients receiving palliative care.

2. However, DADDS scores were not associated with patient demographic factors, including religious affiliation and intrinsic religiousness.

Evidence Rating Level: 2 (Good)

Terminally ill patients may suffer from significant psychological burdens, including death anxiety and distress. Though one of the objectives of palliative care is to address this, the burden of death anxiety has not been well-characterized in these patients. As a result, the objective of the present study was to evaluate the effects of death anxiety on various clinical parameters in cancer patients receiving palliative care.

The present study was an ancillary study to a previous stepped-wedged randomized controlled trial on dignity therapy in the United States. It included a convenience sample of 167 patients who had received the dignity therapy intervention. Patients were included if they were 55 years of age or older, had a cancer diagnosis, were receiving outpatient palliative care, and had a palliative performance scale score (PPS) of >50. Patients were excluded if they were legally blind or cognitively impaired. Patients completed the Death Anxiety and Distress Scale (DADDS), and information on demographic variables, diagnosis, terminal illness awareness, and religious involvement was obtained. Dignity-related distress was assessed with the Personal Dignity Inventory, and existential quality of life was assessed using the Preparation and Completion subscales of the quality of life at end of life (QUAL-E) questionnaire. The primary outcome was the association between death anxiety and several physical and psychosocial factors.

The results demonstrated a positive association between DADDS scores and both religious struggle and dignity-related distress, but a negative correlation with existential quality of life. There was also an association between terminal illness awareness and DADDS scores. However, DADDS scores were not associated with patient demographic factors such as religious affiliation, frequency of prayer, etc. Despite these results, the study was limited by a relatively homogenous convenience sample which may affect generalizability. Nonetheless, the present study demonstrated that quantifying death anxiety may play an important role in understanding the psychological burden experienced by cancer patients.

Click to read the study in Journal of Palliative Medicine

Image: PD

©2023 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.